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Using Deep Learning to Automate Goldmann Applanation Tonometry Readings.

Publication ,  Journal Article
Spaide, T; Wu, Y; Yanagihara, RT; Feng, S; Ghabra, O; Yi, JS; Chen, PP; Moses, F; Lee, AY; Wen, JC
Published in: Ophthalmology
November 2020

PURPOSE: To develop an objective and automated method for measuring intraocular pressure using deep learning and fixed-force Goldmann applanation tonometry (GAT) techniques. DESIGN: Prospective cross-sectional study. PARTICIPANTS: Patients from an academic glaucoma practice. METHODS: Intraocular pressure was estimated by analyzing videos recorded using a standard slit-lamp microscope and fixed-force GAT. Video frames were labeled to identify the outline of the reference tonometer and the applanation mires. A deep learning model was trained to localize and segment the tonometer and mires. Intraocular pressure values were calculated from the deep learning-predicted tonometer and mire diameters using the Imbert-Fick formula. A separate test set was collected prospectively in which standard and automated GAT measurements were collected in random order by 2 independent masked observers to assess the deep learning model as well as interobserver variability. MAIN OUTCOME MEASURES: Intraocular pressure measurements between standard and automated methods were compared. RESULTS: Two hundred sixty-three eyes of 135 patients were included in the training and validation videos. For the test set, 50 eyes from 25 participants were included. Each eye was measured by 2 observers, resulting in 100 videos. Within the test set, the mean difference between automated and standard GAT results was -0.9 mmHg (95% limits of agreement [LoA], -5.4 to 3.6 mmHg). Mean difference between the 2 observers using standard GAT was 0.09 mmHg (LoA,-3.8 to 4.0 mmHg). Mean difference between the 2 observers using automated GAT videos was -0.3 mmHg (LoA, -4.1 to 3.5 mmHg). The coefficients of repeatability for automated and standard GAT were 3.8 and 3.9 mmHg, respectively. The bias for even-numbered measurements was reduced when using automated GAT. CONCLUSIONS: Preliminary measurements using deep learning to automate GAT demonstrate results comparable with those of standard GAT. Automated GAT has the potential to improve on our current GAT measurement standards significantly by reducing bias and improving repeatability. In addition, ocular pulse amplitudes could be observed using this technique.

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Published In

Ophthalmology

DOI

EISSN

1549-4713

Publication Date

November 2020

Volume

127

Issue

11

Start / End Page

1498 / 1506

Location

United States

Related Subject Headings

  • Tonometry, Ocular
  • Reproducibility of Results
  • ROC Curve
  • Prospective Studies
  • Ophthalmology & Optometry
  • Middle Aged
  • Male
  • Intraocular Pressure
  • Humans
  • Glaucoma
 

Citation

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Spaide, T., Wu, Y., Yanagihara, R. T., Feng, S., Ghabra, O., Yi, J. S., … Wen, J. C. (2020). Using Deep Learning to Automate Goldmann Applanation Tonometry Readings. Ophthalmology, 127(11), 1498–1506. https://doi.org/10.1016/j.ophtha.2020.04.033
Spaide, Ted, Yue Wu, Ryan T. Yanagihara, Shu Feng, Omar Ghabra, Jonathan S. Yi, Philip P. Chen, Francy Moses, Aaron Y. Lee, and Joanne C. Wen. “Using Deep Learning to Automate Goldmann Applanation Tonometry Readings.Ophthalmology 127, no. 11 (November 2020): 1498–1506. https://doi.org/10.1016/j.ophtha.2020.04.033.
Spaide T, Wu Y, Yanagihara RT, Feng S, Ghabra O, Yi JS, et al. Using Deep Learning to Automate Goldmann Applanation Tonometry Readings. Ophthalmology. 2020 Nov;127(11):1498–506.
Spaide, Ted, et al. “Using Deep Learning to Automate Goldmann Applanation Tonometry Readings.Ophthalmology, vol. 127, no. 11, Nov. 2020, pp. 1498–506. Pubmed, doi:10.1016/j.ophtha.2020.04.033.
Spaide T, Wu Y, Yanagihara RT, Feng S, Ghabra O, Yi JS, Chen PP, Moses F, Lee AY, Wen JC. Using Deep Learning to Automate Goldmann Applanation Tonometry Readings. Ophthalmology. 2020 Nov;127(11):1498–1506.
Journal cover image

Published In

Ophthalmology

DOI

EISSN

1549-4713

Publication Date

November 2020

Volume

127

Issue

11

Start / End Page

1498 / 1506

Location

United States

Related Subject Headings

  • Tonometry, Ocular
  • Reproducibility of Results
  • ROC Curve
  • Prospective Studies
  • Ophthalmology & Optometry
  • Middle Aged
  • Male
  • Intraocular Pressure
  • Humans
  • Glaucoma